A patient was admitted to the department of internal medicine due to cardiac decompensation (dyspnea, lower limbs swelling). Echocardiography was not performed; the patient´s medical history was unremarkable. During the therapy at the standard ward, the patient fell and broke his femoral neck.
Gamma-nail was operatively inserted on the following day. After extubation, severe bradycardia and even asystole happened. Followed short CPR with the administration of 1 mg of adrenaline, the patient was reintubated and mechanical ventilated. Echocardiography revealed overload of the right ventricle. CT pulmonary angiography excluded pulmonary embolism, and the patient was admitted to the ICU. Severe bradycardia appeared once more, needed of 1 mg adrenaline and short CPR, without further bradycardia.
Echocardiography was performed after admission to ICU: